The nurse is caring for a client with diabetes who is having a hard time managing blood glucose levels. Using Bronfenbrenner's Socio-Ecological Model, which factor would the nurse identify as most likely contributing to the client's difficulty managing their diabetes at the exosystem level?

Correct Answer: A

Rationale: The correct answer is A: Limited access to healthy food options. At the exosystem level of Bronfenbrenner's model, environmental factors impact individuals indirectly. Limited access to healthy food options can hinder the client's ability to make nutritious choices, leading to poor blood glucose management. This factor influences the client's social and physical environment, contributing significantly to their difficulty in managing diabetes. Summary: B: Family history of diabetes is at the microsystem level, involving direct relationships and interactions. While it may predispose the client to diabetes, it does not directly affect their current struggles with managing blood glucose levels. C: Sedentary job is also at the microsystem level and can impact physical activity but is not as influential in blood glucose management as access to healthy food. D: Lack of reliable transportation is at the mesosystem level, involving connections between microsystems. While it can affect access to healthcare, it is not as directly related to dietary choices impacting blood glucose levels.

Correct Answer: D

Rationale: The 1976 ruling in Estelle v. Gamble established that incarcerated individuals have a constitutional right to receive adequate health care while in custody. This principle is reflected in choice D, which is the correct answer. The ruling emphasized the responsibility of correctional facilities to provide necessary medical care to ensure the well-being of inmates. Choices A, B, and C are incorrect because they do not directly align with the specific principle established in the Estelle v. Gamble case. Accreditation, health information privacy, and autonomy over health care decisions are important aspects of correctional health care but were not the primary focus of this particular ruling.

Correct Answer: C

Rationale: The correct answer is C because the Nurse Practice Act is a state law that defines the scope of practice for nurses, including school nurses. This law outlines the specific duties, responsibilities, and limitations of nurses in that state, ensuring they practice safely and within legal boundaries. Choice A is incorrect as it doesn't address the legal framework. Choice B is incorrect because the Nurse Practice Act supersedes any job description set by the school district. Choice D is incomplete and irrelevant to the question.

Correct Answer: B

Rationale: The correct answer is B because administering medication for the treatment of hepatitis C falls under tertiary health promotion, which focuses on managing and treating long-term diseases to prevent complications. Teaching rescue inhaler use (A) is more related to secondary prevention. Advocating for low-sodium dietary options (C) and recommending physical therapy (D) are examples of primary prevention strategies.

Correct Answer: D

Rationale: The correct answer is D (A and C). Independent assortment of chromosomes occurs during meiosis when homologous chromosomes separate randomly, leading to genetic variation in offspring. Recombination, or crossing over, also occurs during meiosis when genetic material is exchanged between homologous chromosomes, further increasing genetic diversity. Mutation (choice B) can occur in both sexual and asexual reproduction, so it is not specific to sexual reproduction. Choice D is correct because both independent assortment and recombination are unique mechanisms of genetic change in sexual reproduction, leading to genetic variation in offspring.